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Laser Spine Surgery

 

Minimally Invasive Laser Spine Surgery is now a possibility with advances in modern medicine, however, most spine surgeons unfortunately aren't yet able to perform this innovative technique.

 

See why Laser Spine Surgery is unlike other typical treatments and how it has changed the lives of thousands.

 

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Track Record

Laser Spine Surgery has a great success rate treating spine disorders from herniated discs, bulging discs, spinal stenosis, foraminal stenosis, spinal arthritis, sciatica, bone spurs and many other spine conditions.  Many patients are referred by past clients.  

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Success Rates of Back Surgery Types

 

Understanding the success rates of your surgical treatment options is important to have accurate expectations for the outcome of your surgery.  Further, the success rate is influenced by the amount of nerve damage you may have, if you have had any prior surgeries, proper selection of the patient, skill of the surgeon, general health of the patient, and the part of the spine the surgery will occur.  Keep this in mind when looking at the success rates of the different procedures.

A successful surgery is defined as an operation that results in complete or significant improvement upon a condition and would be rated as good or excellent by the patient.  An unsuccessful surgery would be one which left the patient's condition unchanged or worse than it was before and is referred to as a failed back surgery.


Basically, there are six main types of surgical procedures; Diskectomy, Laminotomy, Foraminotomy, Spinal Fusion, Artificial Disk Replacement, and Vertebroplasty.  A description of each type of surgery and a study highlighting the success rates of various surgical operations are listed below.

Minimally invasive laser surgery can normally be performed for a Diskectonmy, Laminotomy, and Foraminotomy procedures.  Go to the bottom of the page here to see studies on the success rate of minimally invasive laser surgery.  Contact a Patient Advocate to Consult with the Most Successful Minimally Invasive Laser Spine Surgeons for your type of surgery.

Types and Success Rates of Traditional Back Surgery Procedures



Discectomy

Discectomy is a surgical treatment which is used to remove herniated discs. Herniated discs cause compression in the spine causing severe pain in the back and numbness and weakness in muscles.  This type of surgery can be preformed as an open or minimally invasive procedure. 

Study Highlighted
 
Long-term prospective study of lumbosacral discectomy
By P. Jeffrey Lewis, M.D., Bryce K. A. Weir, M.D., Robert W. Broad, M.D., and Michael G. Grace, Ph.D.
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A long-term prospective study of 100 patients undergoing lumbosacral discectomy was carried out in an attempt to delineate the natural history of these patients and to assess the relative significance of preoperative factors as determinants of long-term outcome. Neurological findings were documented preoperatively and at 1 month, 1 year, and 5 to 10 years postoperatively. A questionnaire using subjective and objective data was given to patients at 1 year and 5 to 10 years postoperatively. An 83% long-term follow-up result was obtained. At a minimum of 5 years postoperatively, 62% of patients had complete relief of back pain and 62% had complete relief of leg pain; 96% were pleased that they had submitted to surgery and 93% were able to return to work. Nine percent reported that their back pain at 5 to 10 years was as severe as or worse than preoperatively and 11% reported that their leg pain was as severe as or worse than preoperatively. The reoperation rate was 18%. Preoperative factors found to be significantly associated with outcome at 1 year postoperatively were not significantly associated with outcome at 5 to 10 years postoperatively. The results of lumbosacral discectomy appear favorable as evaluated in this study. Preoperative factors useful as predictors of short-term outcome are much less reliable when considering the long-term results.

 

Laminotomy

 

A laminotomy involves the removal of part of the bone at the back of the vertabra in the spinal canal to enlarge the spinal canal.  This helps relieve nerve pressure caused by spinal stenosis. This procedure may also be used for treatment of herniated discs, bone spurs (osteophytes) herniated discs, scar tissue formation, and spinal arthritis.  A laminotomy may be done as an open or minimally invasive procedure.


Study Highlighted

 

Long-term results of microsurgical treatment of lumbar spinal stenosis by unilateral laminotomy for bilateral decompression.
By OERTEL Markus F; RYANG Yu-Mi; KORINTH Marcus C.; GILSBACH Joachim M.; ROHDE Veit; MAIMAN Dennis J. ; BRANCH Charles L. ; SONNTAG Volker K. H. ; TRAYNELIS Vincent C. ; WANG Michael Y. ; HEARY Robert F.
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OBJECTIVE: Laminectomy and bilateral laminotomy are the standard procedures for decompression of lumbar spinal stenosis (LSS). With the aim of less invasiveness and better preservation of spinal stability, the technique of unilateral laminotomy for bilateral decompression (ULBD) was developed. However, limited follow-up data exist to determine the efficiency and outcome of ULBD. Therefore, the authors present their 10-year experience with ULBD and postoperative long-term results. METHODS: One hundred thirty-three consecutive patients (73 men and 60 women; mean age, 63 yr) meeting clinical and radiographic criteria for LSS who underwent first-time ULBD between 1994 and 1999 entered the study. The study parameters were set to ensure follow-up period of at least 4 years. All patients were available for short-term follow-up re-evaluation within 3 months, and 102 (77%) of the 133 patients were available for long-term examination after a mean duration of 5.6 years. The scale of Finneson and Cooper was used for evaluation of the clinical results. RESULTS: One hundred thirty patients (97.7%) improved immediately after surgery. Ninety-four (92.2%) of the 102 patients available for long-term follow-up examination remained improved, and 85.3% had an excellent-to-fair operative result. The incidence of complications was 9.8%. Resurgery for complication was necessary in three patients, for restenosis in seven patients, and for spinal instability in two patients, accounting for a reoperation rate of 11.8%. CONCLUSION: ULBD allows achievement of good and long-lasting operative results in patients with LSS. Postoperative deterioration, recurrences, and spinal instability are infrequent. For the authors, ULBD is the preferred technique to treat symptomatic LSS.

Foraminotomy

A Foraminotomy enlarges the foramen which is the space through which the spinal nerves exit from the spinal cord.  If the nerves in the foramen are compressed then there is severe pain in the back and also in the legs.  This procedure is used to treat herniated discs, foraminal stenosis, pinched nerves, scar tissue, arthritis, sciatica, and bone spurs by reducing the compression of the nerve root in the foramen. This operation may be done with open surgery under general anesthesia or minimally invasive endoscopic surgery.

Study Highlighted

 

Long term outcome after cervical foraminotomy 
By Chris Woertgen, Ralf Dirk Rothoerl, Jan Henkel and Alexander Brawanski  
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We recently demonstrated the effectiveness of dorsal foraminotomy in lateral herniated cervical disc after 1 year follow-up in a prospective study.1The goal of this paper is to confirm these results concerning long term outcome. We carried out a prospective, consecutive study on 54 patients, operated on for lateral herniated cervical disc. We analysed demographic data, the case history, the neurological examination on admission and imaging data. Ninety per cent were followed up for 3.5 years postoperatively. According to their ratings on a pain scale the group were divided into favourable and unfavourable outcomes. These groups were analysed in relation to the patient’s initial condition. At follow up, 90% of patients showed complete recovery or improvement. A long standing preoperative neurological deficit seems to be an important prognostic factor for unfavourable long term outcome after cervical foraminotomy. 


Spinal Fusion

Spinal fusion permanently connects two or more bones in your spine. It can relieve pain by adding stability to a spinal fracture. It is occasionally used to eliminate painful motion between vertebrae that can result from a degenerated or injured disk.

Study Highlighted

 

Posterolateral spinal fusion: a study of 123 cases with a long-term follow-up  
By Laus M, Tigani D, Pignatti G, Alfonso C, Malaguti C, Monti C, Giunti A.
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A total of 123 patients submitted to posterolateral fusion according to the Wiltse method were followed-up after 2-10 years (mean 6 years and 2 months). The series included: isthmic spondylolisthesis: 80; degenerative spondylolisthesis: 18; failed back syndrome: 25. Good morphological fusion of the arthrodesis evaluated by conventional radiology and CT, was obtained in 87% of the entire series, while in 89% of the cases excellent or good clinical results were obtained according to the Friberg evaluation scale. Extent of the fusion to 1 or 2 intervertebral segments, or association of laminectomy did not influence the results. Clinical and radiographic results were maintained stable in time: in only 3 cases did we observe clinical deterioration due to degeneration of the segment located above the fusion 3-7 years after surgery. The only important complications observed were one cauda equina syndrome due to peridural hematoma after laminectomy-fusion, and one iliocaval venous thrombosis. The results of the series studied and the data reported in the literature show that posterolateral fusion is a method capable of providing a high percentage of good clinical and radiographic results, and it may be favorably compared with methods of interbody fusion and of pedicular fixation, compared to which it has the advantage of involving a minor number of complications. Anterior interbody fusion is however indicated for stabilization of the reduction of severe spondylolisthesis in the adolescent. Fusion with pedicular osteosynthesis is indicated for the treatment of macroscopic instability and in fusions which are extended to more than two intervertebral segments.

Artificial Disk Replacement

Implanted artificial disks are a treatment alternative to spinal fusion for painful movement between two vertebrae due to a degenerated or injured disk. These relatively new devices are still being studied, however, so it's not yet clear what role they might play in treating spinal disk disease.

 

Study Highlighted

 

Total disc replacement in the lumbar spine: a systematic review of the literature   
By Brian J.C. Freeman and James Davenport 
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The current evidence for total disc replacement was assessed by performing a systematic review of the published literature. This search identified two randomised controlled trials (RCTs), two previous systematic reviews, seven prospective cohort studies, eleven retrospective cohort studies and eight case series. The RCTs involved the use of the Charite artificial disc and the Pro-Disc II total disc replacement. All papers analysed were classified according to their level of evidence as defined by the Centre for Evidence Based Medicine, Oxford, UK (www.cebm). For degenerative disc disease at L4/5 or L5/S1, both the clinical outcome and the incidence of major neurological complications following insertion of the Charite artificial disc were found to be equivalent to those observed following a single level anterior lumbar interbody fusion 2 years following surgery. However, only 57% of patients undergoing total disc replacement and 46% of patients undergoing arthrodesis met the four criteria listed for success. The range of flexion/extension was restored and maintained with the Charite artificial disc. The role for two or three level disc replacement in the treatment of degenerative disc disease remains unproven. To date, no study has shown total disc replacement to be superior to spinal fusion in terms of clinical outcome. The long-term benefits of total disc replacement in preventing adjacent level disc degeneration have yet to be realised. Complications of total disc replacement may not be known for many years. There are numerous types of disc prostheses and designs under study or in development. Well designed prospective RCTs are needed before approval and widespread application of this technology.

 

Vertebroplasty

 

During this procedure, your surgeon injects bone cement into compressed vertebrae. For fractured and compressed vertebrae, this procedure can help stabilize fractures and relieve pain. With a similar but more expensive procedure — called kyphoplasty — a balloon-like device is inserted to attempt to expand compressed vertebrae before bone cement is injected.

Study Highlighted

Vertebroplasty: clinical experience and follow-up results.    
By Martin JB, Jean B, Sugiu K, San Millan Ruiz D, Piotin M, Murphy K, Rufenacht B, Muster M, Rufenacht DA
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This study was undertaken to report the clinical experience with percutaneous minimal invasive vertebroplasty using polymethyl-methacrylcate (PMMA) for a consecutive group of patients. Over the period of the last 4 years, 40 patients were treated at 68 vertebral segment levels with the intention to relieve pain related to vertebral body lesions. Reduced vertebral body height and destruction of the posterior vertebral wall were not considered to be exclusion criterias. The vertebroplasty procedure was performed under general anesthesia and in prone position with imaging control using mostly biplane DSA fluoroscopic guidance, and rarely with single-plane mobile DSA combined with computed tomographic guidance. Unilateral, but more frequently bilateral, transpedicular introduction of a 2-3-mm OD needle was followed by an injection of polymethyl-methacrylcate (PMMA). PMMA preparation involved a diluted mixture (20 mL powder for 5 mL liquid) allowing for an extended polymerization time of up to 8 min. The PMMA was mixed with metallic powder to enhance its radio-opacity. Before PMMA injection, a vertebral phlebography was obtained to evaluate the filling pattern and identify sites of potential PMMA leakage. Injection of opacified PMMA was performed under continuous visual control with fluoroscopy to obtain adequate filling and to avoid important PMMA leakage. Clinical follow-up involved an evaluation using a questionnaire for assessment of pain, pain medication, and mobility. One to six levels were treated in one to three treatment sessions for patients with metastatic, osteoporotic, and hemangiomatous lesions of the vertebral bodies who presented with pain. The results observed matched those reported previously with a success rate of approximately 80% and a complication rate below 6% per treated level. Treatment failure and complications observed were related to leakage, insufficient pretreatment evaluation, anesthesia, or patient position during treatment. Image guidance with fluoroscopy was efficient both for precise transpedicular approach and PMMA implantation control. Vertebroplasty is very efficient for treatment of pain. Treatment failure was mostly related to insufficient pretreatment clinical evaluation, and complication due to excessive PMMA volume injection. Control of PMMA volume seems to be the most critical point for avoiding complications. A good fluoroscopy control is therefore mandatory.
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